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  <title>Aliens Abducted Me - Report an Abduction</title>
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  <h2>Aliens Abducted Me - Report an Abduction</h2>

  <p>Share your story of alien abduction:</p>
  <form method="post" action="report.php">
    <label for="firstname">First name:</label>
    <input type="text" name="firstname" /><br />
    <label for="lastname">Last name:</label>
    <input type="text" name="lastname" /><br />
    <label for="email">What is your email address?</label>
    <input type="text" name="email" /><br />
    <label for="whenithappened">When did it happen?</label>
    <input type="text" name="whenithappened" /><br />
    <label for="howlong">How long were you gone?</label>
    <input type="text" name="howlong" /><br />
    <label for="howmany">How many did you see?</label>
    <input type="text" name="howmany" /><br />
    <label for="aliendescription">Describe them:</label>
    <input type="text" name="aliendescription" size="32" /><br />
    <label for="whattheydid">What did they do to you?</label>
    <input type="text" name="whattheydid" size="32" /><br />
    <label for="fangspotted">Have you seen my dog Fang?</label>
    Yes <input name="fangspotted" type="radio" value="yes" />
    No <input name="fangspotted" type="radio" value="no" /><br />
    <img src="fang.jpg" width="100" height="175"
      alt="My abducted dog Fang." /><br />
    <label for="other">Anything else you want to add?</label>
    <textarea name="other"></textarea><br />
    <input type="submit" value="Report Abduction" name="submit" />
  </form>
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